Permit .-A CITY OF TIGAR p SEWER CONNECTION PERMIT
,�1 DEVELOPMENT SERVIC PERMIT #: SWR1999 -00211 •
' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 666/V441 DATE ISSUED: 10/14/99
SITE ADDRESS; 11955 SW TREEVIEW CT PARCEL: 2S110BB -06600
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 008 JURISDICTION: TIG
TENANT NAME: J R ROTH
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: New single family residence.
Owner:
FEES
J T ROTH JR
12600 SW 72ND AVE #200 Type - By Date Amount Receipt
TIGARD, OR 97223 PRMT DEB 10/14/99 $2,300.00 99- 319094
INSP DEB 10/14/99 $35.00 99- 319094
Phone: 639 -2639 • Total $2,335.00
Contractor: •
Phone:
Reg #:
Required Inspections
Sewer Inspection
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This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the • -• • on I i ' • otification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0080.
You , ay obtain copies o f these rule: •r dir- questions to OUNC by calling (503) 246 -1987.
Is ued by: ' Permittee Signature: –410% %
Call (503) 639 5 by 7:00 P.M. for an inspection needed the next bu • ess day
7
CITY OF TIGARD BUILDING INSPECTION DIVISION MST / -136 330
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1.1 / /.' I n 11 AM PM BLD
Location ( (qSS .S& 1 (LU (cu) ( Suite MEC
Contact Person Ph 5l? - 337.5 PLM
Contractor 3H &IL/ Ph SWR 1 � 51 I
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Drain SGN
Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
�� PART FAIL
BING
Post & Beam I � (-
Under Slab - �V
Top Out
Water Service
n '
rams
F'
PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D a e Inspector ® r Exr '
Date 9.
Final
PASS PART FAIL D • NO REMOVE this inspection record from the job site